HomeMy WebLinkAboutR 2019-472 Aging - Nina Maier wellness instructor DocuSign Envelope ID: 1546E635-90E6-47DB-A413-373CA8A49D89
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Nina Maier Party/Vendor Contact Person: Contact Phone: Party/Vendor Address:
3302 Pearson Rd City Hurdle Mills State: NC Zip: 27541 Department: Aging Amount: $3,500 Purpose: Wellness
Instructor Budget Code(s): 29430320-630000 Vendor#51178 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date 07/01/2019
Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
DocuSigned by::- '_ 7/17/2019
Department Director's Signature �aan.iGt, �+�b_r Date:
Agreements for emergency services of UE962D1BF454FA.. A to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that was
addressed:
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications,and requirements:
DocuSigned by:
sa LQ 6
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Office of the Risk Management Officer U Date: 7/18/2019
7FDCF9176800498.
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSigned by:
7/19/2019
Office of the Chief Financial Officer lr7NE5181ACC1409
s��rx.wra Date:
.
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney ��,O Date:
7/19/2019
4035CB8304CA4Ae
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 12/18 4